When a horse is recumbent (down and unable to get up) in a tight spot, one of the first individuals an emotional owner calls is the veterinarian. It’s important that vets and technicians know how to safely and effectively restrain these horses, so they can be extracted and helped back to their feet without injuring themselves or the people around them. However, most veterinarians only gain experience restraining recumbent horses when they’re faced with one.

Rebecca Husted, PhD, president of Technical Large Animal Emergency Rescue Inc., described safe restraint practices during a presentation at the 2020 American Association of Equine Practitioner’s Convention, held virtually.

“Recumbent horses are notoriously difficult to safely restrain,” she said. “And in the real world, there’s never much help, there’s never a calm horse, and it’s usually not on a warm, sunny day.”

Additionally, the spaces veterinarians typically find themselves—in horse trailers, ditches, stalls—are dangerous places to be with a panicky large animal.

“It’s a confined space with a ticking time bomb in it, so we want to be a little safer in how we approach these kinds of situations,” she said.

Steps To Take

Before putting yourself in a potentially dangerous situation with a trapped or down horse, Husted urged all veterinarians and handlers to don personal protective equipment (PPE) such as helmets, gloves, and boots.

In most scenarios, the veterinarian will first anesthetize or sedate the down horse to reduce its chances of injuring anyone if it flails around trying to stand. Husted recommends using a pad or blindfold (even a T-shirt or blanket) to protect the horse’s downside eye and cover the upside eye, adding that equine eye and head protection has improved significantly over the years, with today’s head protectors equipped with handles that make it easier and safer to manipulate the horse’s head and neck.

The goal is then to get the horse into a supported sternal position, where he can more easily get back on his feet, she said.

The Foot-on-Neck Method

Historically, said Husted, handlers—herself included—have followed a “knee-in-the-neck, tip-the-nose-up” method for restraining down horses. Tipping the nose up delays the horse’s attempts to roll into a sternal position, then stand. Sitting or kneeling on the horse’s neck and head, however, is an unreliable way to restrain it and dangerous for handlers, she said, because few people are strong enough to keep a horse down if it’s determined to stand.

Therefore, Husted now advocates for standing, using the lead rope for leverage to tip the horse’s nose skyward, and placing your foot in the atlanto-occipital space (between the skull and the first vertebrae) to discourage the horse from rising. She said its benefits include:

• Being more ergonomically correct for your body.
• Giving the handler more leverage and better balance.
• The ability to quickly step away to safety if the horse struggles violently.
• Allowing the handler to view the entire scene.
• Allowing the veterinarian to perform tasks such as accessing the jugular for catheter insertion and maintenance and assessing pulse, ocular reflexes, mucous membrane, and capillary refill time.

She recommends a handler maintain control of the horse’s head in this manner until the veterinarian has evaluated and treated him and he’s recovered or been extracted. Meanwhile, avoid standing dangerous positions such as directly in front of the legs or head, between the legs, or over a recumbent horse.

“Use of these methods and simple equipment with PPE will contribute to effective equine restraint, improved ergonomic and kinetic safety for veterinarians, handlers, and personnel while allowing successful and efficient outcomes of lateral recumbency in clinical, field, and technical rescue incidents,” she concluded.